常规应用基于三维食道外心声学的设备选择,用于通过导管关闭心房隔膜缺陷,而不需要气球大小测量
Pil Hyung Lee1, Ga Yun Kim1, Jae Sung Yu1
1Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
European heart journal. Cardiovascular Imaging
|January 14, 2026
概括
一个3D透食管回声心电图 (TEE) 尺寸策略提供了一种安全有效的方法,用于通过导管关闭心房隔膜缺陷 (ASD). 这种方法有助于避免低估ASD大小,特别是在具有不同方向的圆形缺陷.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 目前还没有一个标准化的全球框架,用于通过导管关闭心房隔膜缺陷 (ASD) 的设备大小选择.
- 目前的方法可能会导致尺寸不准确,特别是复杂的ASD解剖学.
研究的目的:
- 评估基于ASD关闭的3D过食道心声学 (TEE) 设备选择策略的常规应用所产生的结果和见解.
- 在大量患者队列中评估程序前基于3D TEE的尺寸测量的安全性和有效性.
主要方法:
- 使用了前性注册表 (ASD_3D_Device_Size),从2016年9月到2024年5月,注册了748名患者.
- 设备尺寸仅在程序前确定,使用基于3D TEE的公式.
- 患者在治疗后的临床随访时间中位数为1.6年.
主要成果:
- 手术的成功率高达99.5%,重新选择率低 (0.1%),栓塞率低 (0.4%),位置不良 (0.1%).
- 计算模拟显示,标准光学气球尺寸可以低估圆形ASD的最大直径高达34.9%,由于不同的方向.
- 在随访期间,一名患者因心脏侵蚀而需要手术.
结论:
- 使用3D TEE进行手术前设备大小测量是ASD关闭例行临床实践的安全和实用的框架.
- 圆形ASD最大直径的不同方向需要先进的成像技术,以避免传统大小测量方法的低估.
- 这一策略提高了跨导管ASD干预的程序安全性和有效性.
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